Volunteer Application

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IN CASE OF EMERGENCY, CONTACT:

What days and time do you prefer to volunteer?:

Please consider carefully:

(Conviction of crime does not necessarily disqualify the applicant from consideration. A crime includes the conviction of a Class A, Class B, Class C, Class D, or Class E crime in Maine, or a misdemeanor or felony in another state)

Northern Light Home Care & Hospice provides volunteer opportunities to qualified applicants without regard to race, color, religion, sex, age, ancestry or national origin and mental or physical disability. No question on this application is intended to secure information to be used for discriminatory purposes.

Volunteer position offers are contingent upon:
  1. Receipt of acceptable recommendations from references.
  2. Departmental or program leader approval.
  3. Completion of the Volunteer Health Screening and release, including TB screening and Rubella, Rubeola, Mumps and Chicken Pox immunizations (if needed).
  4. Criminal background check
  5. Driving History Check

We are happy to include your health specialists in making reasonable accommodations for your success.

Consideration for certain volunteer positions requires additional screenings and will be discussed at time of offer.

The information provided by me on this application is correct and complete to the best of my knowledge and belief. I understand that any false or misleading statements made on this application may result in refusal of my volunteer service.

I authorize Northern Light Home Care & Hospice to verify any information in the application and to contact my references.

I understand that volunteer services for Northern Light Home Care & Hospice are always based on the ongoing mutual agreement of the agency and the volunteer.
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